Tuesday, September 03, 2013

The New Normal

The first thing most people ask me when I tell them I had skin cancer is, "How did you know you had it?" My response is that I've had this mole on my shin for a couple of years now, about the size of the tip of a pencil eraser; but over the last few months, I noticed that it changed. I can't tell you exactly why I noticed the change -- maybe it's because it was on the front of my leg, but it went from just another spot to an ugly spot.

At first, all I cared about was getting it removed; but as time passed, the color change and shape looked -- I dunno -- weird, for lack of a better term. So, I went to my dermatologist who took a close look and confirmed my suspicions: It didn't look good. She took a shave biopsy and told me she'd call as soon as she received the results.

Her follow-up call was left in voice mail and I knew it wasn't good news when I heard her say, "We need to develop a game plan." No one develops a game plan for carrying on with their lives -- it's only when the game changes.

When I called, she sounded very upbeat - or at least, she tried to sound upbeat; I listened to her calmly and carefully, asking questions I had already thought about once I heard her voicemail; but by the end of the conversation, she said, "This sucks, I know." I wasn't really sure how to respond to that. I mean, maybe I was still ignorant of the long road ahead, but I couldn't grasp the "it sucks" part because I didn't feel any different than I did before I went in to see her. So I replied with, "Can I still go on vacation next week?" She couldn't give me an answer, but she told me she would get me in to see a plastic surgeon for a consult the next day so I could get the surgery scheduled.

The irony of all ironies is that our six year-old dog, Scout, died from melanoma in April. It started with a tumor on his paw, which was removed (along with a non weight-bearing toe) to full blown masses growing in his upper GI tract five months later. The sad thing is that we had put him on a melanoma vaccine program after his tumor had been removed (they actually have a melanoma vaccine for dogs...not for people yet -- it's still in experimental stages) and it didn't help one bit.

When you're diagnosed with cancer -- whether you're a dog or a person, you're given a number on a mitotic index, which indicates the number of cancer cells that are dividing. So, for instance, Scout's mitotic index was at 19. Mine was only a 1. I guess that's why, initially, I wasn't consumed with fear about my diagnosis.

But then, of course, my fears grew after speaking to the reconstructive surgeon the next day. It wasn't just because we didn't know how far it had spread; it was what she had to do to take it out and ensure it hadn't spread.

After she told me that she had to cut a centimeter around my little eraser-tip mole (which, you know, doesn't seem like a lot until you see a diagram on your shin), she explained that she would either have to make a skin flap or take a skin graft from another area to patch it up. After the surgery, I would have to be on bed rest for a few weeks and then walk with crutches for a few weeks more, until the wound closed and the stitches were removed.

What was worse was that she told me I would have to have a lymph node biopsy in my groin (since those are the lymph nodes closest to my shin). The procedure involved injecting radioactive dye into my mole site, prior to the leg surgery. Once the radioactive dye traveled to the closest lymph nodes, it would "light them up" so to speak, so that radiologists could pinpoint which nodes would be affected by the melanoma.

After her explanation, I asked her if she thought I could go on vacation for a month prior to the surgery, or if she felt I had to have it done ASAP. The very fact that she replied, "by all means, go on vacation" without any hesitation, put me more at ease.

Let me back up by saying that I'd have been all too happy to scrap my vacation plans if necessary. It's just that the Mr. and I made plans to go to Croatia, Poland, and Ireland for an entire month, and he was already over in Poland at the time of my diagnosis, and the kids were already booked to fly to Michigan the next day. Part of me was relieved I didn't have to have surgery right away and in hindsight, I'm really glad I went because I came back much more relaxed rather than the jumbled ball of nerves I had become this year. Everything had changed this year. We went from having two dogs to having to put two dogs to sleep; My brother had a heart attack at age 55; I went from marathon running to being an injured mess who could barely walk and needed an orthopedic boot to get around (yes, I wore said boot to Europe. No, it wasn't on my leg with the melanoma). Now, I needed surgery to remove skin cancer. To top everything off, my blood pressure has been sky-high (gee, wonder why?). Unpredictability was the new normal.

I was back from vacation by July 16 and my surgery was scheduled for July 20. How's that for coming in hot?

The good news is that the surgery was a success. The margins around my melanoma were clean and the surgeon removed three lymph nodes from my groin -- none of which had any cancer cells.

The bad news is superficial: my leg looks disgusting right now and while I'm off crutches, finally, I still have significant swelling in my leg -- particularly around my ankle. So I'm required to wear compression socks until that stops. I'm glad they're all the rage now because I got mine in all sorts of colors...but I still look like a total dufus wearing them.

The even better news is that because of my significant downtime, my foot has been healing nicely and I'm off the boot...but have to wear orthotics...so I look and feel like an old lady. I'm not sure when I'll be able to run again but once I get the go ahead from my surgeon, I'll give it a go. I can't NOT run and I'm convinced that's one of the reasons why my blood pressure's through the roof.

Given all the lemons handed to me this year, I've been able to make a huge batch of lemonade. Sure, sure, the stuff I've gone through this year was rough; but I'm alive and I'm cancer-free and I now know I'll have to get checked every three months; plus, there's a good chance I'll develop another melanoma (I mean, geeze, I have over 300 moles) and that's the new normal.

So -- lemonade anyone?